Levels Of Anxiety Research Articles

This experimental psychological study featured the perception and evaluation of emotional disorders in married couples. It revealed a systemic mutual influence of individual states and perceptual components of relationships, as well as their distortion. The research objective was to identify the characteristics of direct and cross-assessments of emotional disorders in married couples. The analysis involved the methodology of social psychology and gestalt therapy. Emotional states (disorders) were studied with the help of direct and crossassessments. Each of the spouses performed the techniques first for themselves (self-observation, direct assessment) and then for each other (cross-assessment), based on their observations, interaction experience, and interpersonal relations. The phenomenology of the perception of emotional states was described in terms of contact interruptions in gestalt therapy as isolation, confluence, expectation of confluence, projection, and contact. They correlated with six possible combinations of spouse’s evaluations. The levels of depression, anxiety, and asthenia in 44 married couples were subjected to BDI, HADS, and FIS techniques followed by correlation analysis. It resulted in a new method that correlated the system of received evaluations and the number of reliable and significant connections with psychological mechanisms of interruptions. The expression of mechanisms of social perception (interruptions) that affected the assessments of emotional state in married couples was as follows: 78% contact, 78% projection, 55% expectation of confluence, 22% confluence, 8% isolation. When objectivizing the individual assessment of emotional state, the 22% distortion has to be taken into account as a tendency to exaggerate the severity of symptoms in the partner. This interpretation model can be used for family psychodiagnostics, psychotherapy, and psychoprophylaxis.

Fear of negative evaluation is a diagnostic criterion for social anxiety disorder (SAD). Research demonstrates this may not always occur in autistic individuals who have other markers of SAD. We aimed to characterize fear of negative evaluation in autistic children utilizing a sample of 239 autistic youth ages 10-16. Participants completed self-report questionnaires of social anxiety and fear of negative evaluation. They also participated in a conversation task coded by trained observers to measure social anxiety. Although self-reports of social anxiety and fear of negative evaluation were strongly correlated, they did not match in-the-moment coding of social anxiety from trained observers; this may be partially explained by differences between state and trait experience and the conversational environment. Furthermore, greater levels of autistic traits related to higher levels of social anxiety and to fear of negative evaluation. Fear of negative evaluation, which is the primary cognitive process involved in social anxiety, was strongly associated with social anxiety in this autistic sample of youth.

Anxiety and depression are significant public health concerns influenced by socio-economic factors. This study investigates the associations between socio-economic variables and levels of anxiety, mental health knowledge, and depression in a sample of 425 Lebanese adults. A cross-sectional study was conducted using validated self-reported questionnaires to assess anxiety, depression, and mental health knowledge. Bivariate analyses were performed to examine correlations between socio-economic and paramedical factors and mental health outcomes. The mean mental health knowledge score was 51.83 ± 11.22. The average depression score was 10.0 ± 7.22), and the average anxiety score was 9.46 ± 6.06). Moderate to severe depression was observed in 41.4% of participants, and moderate to severe anxiety in 36.6%. Adverse employment changes, low income, and low education levels were significantly associated with higher levels of anxiety and depression (p < 0.001). Individuals with middle income and higher education had significantly better mental health knowledge. Interestingly, high-income individuals had lower knowledge scores. Socio-economic status plays a crucial role in shaping mental health outcomes, with financial insecurity and unemployment emerging as key risk factors for anxiety and depression. Strengthening mental health education, particularly among socio-economically disadvantaged groups, and promoting workplace mental health awareness programs could help mitigate these effects.

Odor Hedonic Profile (OHP): A sensitive tool in depressive populations.

Breast cancer surgery is often associated with unpleasant postoperative symptoms, including pain, nausea, fatigue, and emotional distress, which can reduce quality of life and prolong recovery times. This study aimed to test the efficacy of preoperative hypnosis in reducing postoperative symptoms following breast cancer surgery. A total of 203 women scheduled for breast cancer surgery at Oslo University Hospital, Norway, participated in a randomized controlled trial. Patients were randomized to receive either a single session of preoperative hypnosis or of mindfulness within two hours prior to their scheduled surgery. Primary outcomes were postoperative pain, fatigue, nausea, discomfort, and emotional distress, measured using 100mm visual analogue scales on the day of surgery following recovery from general anesthesia. Additional measures included amount of intraoperative and postoperative anesthesia and analgesia, as well as surgery duration (extracted from patients' medical records). Patients receiving preoperative hypnosis reported significantly lower postoperative fatigue (mean difference (MD) 6.4, 95% CI 0.40 - 12.4, Cohen's d=0.30) and emotional distress (MD 5.7, 95% CI 0.24 - 11.2, d=0.24) when compared to patients in a mindfulness control group. There was also a significant reduction in postoperative fentanyl use among those patients receiving preoperative hypnosis (MD -0.03, 95% CI -0.047 - -0.005, d=0.54). Preoperative anxiety moderated the effect of hypnosis on postoperative emotional distress, showing a more pronounced benefit for patients with high levels of preoperative anxiety. However, no significant differences were found in postoperative pain, nausea, or discomfort between the hypnosis and mindfulness groups. No adverse events attributed to the interventions were reported. A brief preoperative hypnosis session before breast cancer surgery appears to be more effective than mindfulness in reducing postoperative fatigue, emotional distress, and fentanyl dose. Hypnosis stands out as a promising, non-pharmacological, and safe intervention for reducing certain postoperative symptoms.

To analyse clinical features and psychological status according to the presence of concomitant headache in a well-defined group of temporomandibular disorders (TMD). Graded Chronic Pain Scale and Symptom Checklist-90-Revision were applied to evaluate pain disability and psychological characteristics in a group of 793 TMD patients. The presence of generalised bodily symptoms, sleep disturbance, and general health status was collected. Clinical and psychological variables associated with concomitant headache were statistically identified. Among the TMD patients, 290 reported headache (37%). Those with headache reported higher levels of TMD pain intensity (p = 0.005) and more frequently reported pain on palpation of the masticatory muscles (p = 0.031) and temporomandibular joint (p = 0.007). Also, clenching (p = 0.016), sleep disturbance (p < 0.001), and insomnia (p < 0.001) were more prevalent. Those with headache experienced pain in other body regions more frequently. Higher levels of somatization (p < 0.001), depression (p = 0.045), anxiety (p = 0.005), and paranoid ideation (p = 0.022) were found in the headache group. TMD patients when reporting concomitant headache showed higher pain levels, widespread pain, and higher levels of psychological distress. The results indicate the need to appropriately address the issue of headache in TMD patients with an emphasis on psychological issues to improve overall prognosis.

Female college students of reproductive age are prone to both premenstrual syndrome (PMS) and migraine, with prior epidemiological and clinical studies suggesting a link between these conditions. Nevertheless, the specific predictive factors for migraine among individuals with PMS remain unclear. This multi-center study aimed to assess the prevalence of migraine among female college students with PMS and, through a comparison between those with and without migraine, identify potential predictive factors for migraine in this PMS cohort. Using a cluster sampling approach, general demographic information was collected from 3131 female students across nine institutions in northeastern Sichuan Province, China. Participants were assessed using the Premenstrual Symptoms Screening Tool (PSST) to identify PMS, and the ID-Migraine questionnaire to screen for migraine. Additional measures included the Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), and Mobile Phone Addiction Index (MPAI) to evaluate mental health, sleep quality, and mobile phone dependency, respectively. The results showed a migraine prevalence of 18.8% among female students with PMS. Those with migraine had significantly worse sleep quality (P < 0.001) and higher levels of depression (P = 0.002), anxiety (P < 0.001), and stress (P < 0.001) compared to those without migraine. Multivariate logistic regression analysis revealed that decreased sleep quality (OR = 1.08, P = 0.002) and anxiety (OR = 1.24, P = 0.039) were significant independent risk factors for migraine. The findings suggest that among female college students with PMS, decreased sleep quality and anxiety are associated with migraine, underscoring the importance of incorporating mental health and sleep education into preventive strategies.

Leprosy is a chronic disease that severely affects the skin and nerves, sometimes leading to disability. The deformities deepen stigma and discrimination, even among patients who have been cured. Consequently, leprosy patients are more likely to suffer from mental illnesses than other diseases. A cross-sectional study was conducted in four Chinese provinces (Fujian, Yunnan, Shandong, and Guizhou), including patients who had completed the full course of multidrug therapy (MDT). We assessed anxiety and depression using the SAS and SDS scales, and functional ability using the ADLs. Influencing factors were analyzed with multiple linear regression, and structural equation modeling (SEM) was used to examine the relationships between anxiety, depression. A total of 382 valid questionnaires were received, with a participation rate of 95.5%. Among the participants, 24.08% reported anxiety, 22.51% reported depression, 45.81% experienced impairments in ADLs, and 65.18% had at least one of these conditions. Notably, 3.66% of patients experienced anxiety, depression, and ADL impairments concurrently. Multiple linear regression results showed that the No. of other chronic diseases (P = 0.004), income (P = 0.016), live with patients (P = 0.005), and other ethnic (P<0.001) have a significant correlation with anxiety (R2 = 0.546). Duration of disease (P = 0.014), No. of other chronic diseases (P = 0.000), live with patients (P = 0.015), and live with family (P = 0.040) were associated with depression (R2 = 0.155). SEM results indicated that the paths SDS-SAS, SDS-No.of other chronic diseases, and ADLs-SAS had the highest direct effects of 0.75(95CI%:0.656 ~ 0.834), 0.56(95%CI:0.103 ~ 1.016) and - 0.33(95%CI:-0.490~-0-165). The association between SAS and the (No.of other chronic diseases) was also indirectly influenced by SDS (0.420), exceeding the direct effect (0.040). Similarly, the indirect effect (-0.240) of SAS between SDS and ADLs was higher than the direct effect (-0.100). This study demonstrates that Chinese leprosy patients exhibit high levels of anxiety and depression, which are associated with impaired daily functioning. Mental health is influenced by multiple factors, including comorbid chronic diseases, living arrangements, disease duration, ADLs, income, and ethnicity. SEM revealed that anxiety mediates the impact of depression on functional limitations, highlighting the complex interplay between psychological factors and physical functioning. These findings underscore the need for comprehensive care strategies and psychosocial interventions to improve mental health and overall well-being in leprosy patients.

ABSTRACT The aim of this study was to evaluate the effect of therapeutic toys designed by nursing students on the pain and anxiety levels of sick children before treatment and on the satisfaction of parents and students. The sample consisted of hospitalised children between 3–6 years old, their primary caregivers, and third-year nursing students. Nursing students designed therapeutic toys in the paediatric nursing course and used them to play with children in the experimental group 30 minutes before treatment. The data were collected using Personal Information Form, Student Satisfaction Survey, Parent Satisfaction Survey, Wong-Baker FACES® Scale, and Children’s Fear Scale (CFS). The mean Wong-Baker FACES® scores were significantly lower in the experimental group than in the control group. The experimental group also had a significantly lower mean CFS score than the control group (F = 5.073; p = 0.028; η2 = 0.965). The results also showed that most mothers and nursing students were highly satisfied with the intervention.

The surgery often causes anxiety, which has an impact on physical and psychological conditions of preoperative patients. The data from WHO shows that 50% patients all over the world experienced anxiety, where 5-25% patients are between 5 and 20 years old, and 50% patients are 55 years old. Pre-operational anxiety reaches 534 million patients. Many factors affect anxiety in patients, including family support. This study aims to acknowledge the correlation between family support and anxiety of post-surgery patients in Meuraxa Regional General Hospital, Banda Aceh. This study employs an analytical correlational method with a cross-sectional approach by involving 51 patients selected using an accidental sampling technique. A family support questionnaire is adopted from Nurwulan, with a Cronbach's alpha 0.856. The questionnaire of anxiety using the APAIS scale of Cronbach's alpha 0.825. Univariate and bivariate analysis using the chi-square test. The results indicate that among 51 respondents, the level of anxiety is in a medium state, as 26 respondents (51.0%), family support is in the high category, 47 respondents (92.2%), with a P-value 0.026 (P-value &lt; 0.05). In conclusion, there is a significant relationship between family support and preoperative anxiety at Meuraxa General Hospital Banda Aceh. Families are expected to continuously provide emotional, informational, instrumental, and appraisal support so that patients feel calmer, are able to reduce excessive anxiety, and are better prepared to undergo surgery.

A Study to Assess the Effectiveness of Art Therapy on Anxiety Level among Hospitalized Children in Selected Hospital, Gwalior

This study developed a structured intervention program based on Transformative Learning, Experiential Learning, and Humanistic Education principles to enhance public speaking confidence among university students experiencing public speaking anxiety, a common barrier to academic and professional success. The research had two objectives: (1) to examine the effects of the program on students&amp;rsquo; public speaking confidence and anxiety levels, and (2) to identify the factors influencing the program&amp;rsquo;s success. A mixed-methods approach was employed. Quantitatively, a one-group pretest-posttest design measured changes in self-reported public speaking confidence and anxiety using standardized scales. Qualitatively, participant reflections and interviews were analyzed to uncover supportive factors. The results showed a significant improvement in students&amp;rsquo; self-confidence for public speaking and a corresponding reduction in anxiety after completing the program. Participants reported feeling more comfortable and less fearful when speaking in front of an audience. Key factors contributing to the program&amp;rsquo;s effectiveness included gradual exposure to public speaking tasks, a safe and supportive learning environment, peer feedback, and guided self-reflection. The discussion connects these findings to the theoretical frameworks, explaining how experiential practice, transformative reflection, and humanistic support combined to foster greater confidence. This study offers practical implications for educators seeking to help students overcome public speaking fear, suggesting that incorporating structured practice and supportive pedagogies into the curriculum can substantially improve students&amp;rsquo; public speaking skills and confidence. The article concludes with recommendations for implementing similar programs in higher education and directions for future research.

Autistic adults are highly vulnerable to mental health problems and yet, our understanding of co-occurring psychiatric disorders in this population is limited. Anxiety is one of the most pervasive psychiatric disorders that affects autistic adults. Here, we investigated the association between anxiety, restricted and repeated behaviors and interests (RRB), and challenges in social communication and interaction (CSCI) as a post-hoc analysis of a large Phase 3 clinical trial (NCT03504917). The study enrolled 322 adults (64 females, age 27 ± 10) assessed at baseline and weeks 12, 24, 36, and 52, with the Hamilton Anxiety Rating Scale, the Repetitive Behaviors Scale - Revised, and the Vineland-II for CSCI. All analyses were blind to treatment assignment as the primary study analysis had found no treatment effects. Anxiety levels were significantly correlated with RRB and CSCI at baseline (RRB: r = 0.19, P < 10-3; CSCI=-0.13, P = 0.02) and across the entire study (RRB: r = 0.22, P < 10-3; CSCI=-0.16, P < 0.01). However, a mediation analysis revealed that the effect of CSCI on anxiety was fully explained by RRB (P = 0.17). While no causal relationship between both symptom domains has been established yet, our findings suggest that anxiety symptoms are associated with increased RRB, warranting further exploration of a potential causal association and implications for treatment.Clinical trial registration: The research presented is registered at ClinicalTrials.gov with the code NCT03504917.

Objective This current study examined the serial mediating role of visions about future (hope, optimism, pessimism) and sport anxiety in the relationship between decent work and work engagement among professional athletes. Methods The participants were 296 professional athletes (30.1% female, 69.9% male) aged between 18 and 48, actively competing in football, volleyball, or basketball leagues in Türkiye. Participants completed the Decent Work Scale, Visions About Future Scale, Sport Anxiety Scale, and Utrecht Work Engagement Scale. Structural equation modeling and bootstrapping methods were used for data analysis. Results The results revealed that decent work positively predicted hope, optimism, and work engagement, and negatively predicted pessimism. Optimism negatively predicted sport anxiety, while pessimism positively predicted it. Sport anxiety had a significant negative effect on work engagement. Furthermore, optimism, pessimism, and sport anxiety significantly mediated the relationship between decent work and work engagement in a serial manner. Hope did not significantly mediate this relationship. Conclusion These findings highlight the critical role of professional athletes’ future-oriented cognitions and anxiety levels in translating perceptions of decent work into higher engagement in sport. The study provides valuable insights for psychosocial interventions and organizational policies to enhance athletes’ sustainable careers.

Background Panic disorder (PD) is a disabling anxiety condition in which early improvement during treatment can predict better long-term outcomes. Objectives This study investigated whether a newly developed virtual reality-based assessment tool, the Virtual Reality Assessment of Panic Disorder (VRA-PD), can help predict early treatment response in individuals with PD. Methods In total, 52 participants, including 25 patients diagnosed with PD and 27 healthy individuals, were evaluated every 2 months over a 6-month period. Assessments included self-reported anxiety levels and heart rate variability measured during virtual reality scenarios, as well as standard clinical questionnaires. Patients with PD were further categorized based on their treatment progress into early responders ( n = 7) and delayed responders ( n = 18). A machine-learning model (CatBoost) was used to classify participants into early responder, delayed responder, and healthy control groups. Results The model that combined virtual reality-based and conventional clinical data achieved higher accuracy (85%) and F1-score (0.71) than models using only clinical (accuracy: 77%, F1-score: 0.56) or only virtual reality data (accuracy: 75%, F1-score: 0.64). The most important predictors included anxiety levels during virtual scenarios, heart rate variability metrics, and scores from clinical scales such as the Panic Disorder Severity Scale and Anxiety Sensitivity Index. Conclusions This study highlights the value of virtual reality-based assessments for predicting early treatment outcomes in PD. By providing ecologically valid and individualized measures, virtual reality may enhance clinical decision-making and support personalized mental healthcare.

Background Individual blood pressure levels can be influenced by psychological factors. Objective This study aimed to investigate the relationship between hypertension and psychological states, as well as the underlying mechanisms, using a combination of cross-sectional comparison and experimental intervention. Methods A total of 102 individuals with hypertension and 108 individuals with normal blood pressure participating in pilot selection were recruited. Individuals with hypertension were divided into two intervention groups and a control group: one group received relaxation therapy alone, while the other received a combination of relaxation therapy and cognitive training. Questionnaires were administered to assess anxiety levels and perceived stress. Results The results showed a significant positive correlation between perceived stress and blood pressure in the BBG, and a marginal positive correlation between anxiety and blood pressure. No such correlations were found in the normal blood pressure group. Pre- and post-intervention analyses indicated that the intervention group exhibited a significant reduction in blood pressure compared to baseline levels, along with a notably higher retest pass rate. However, anxiety levels increased significantly across all groups. Conclusion These findings suggest that blood pressure is influenced by anxiety and perceived stress, and psychological interventions can effectively manage blood pressure. However, these interventions may not primarily operate through reducing anxiety, and further research is needed to explore the psychological mechanisms involved.

This research represents the first in the Republic of Kazakhstan focusing on Afghan war veterans identified as being at risk for Post-Traumatic Stress Disorder (PTSD). A comprehensive investigation was undertaken regarding the comorbidity of PTSD symptoms, somatic diseases (cardiovascular and others), and mental disorders. The study’s sample comprised 293 Afghan war veterans, while the control group consisted of 149 males without combat experience. The research methodology incorporated data extracted from medical records, a demographic questionnaire, the Mississippi PTSD Scale (military and civilian versions), the Spielberger–Khanin Anxiety Inventory, the Beck Depression Inventory (BDI), and the SCL-90-R questionnaire. Subclinical symptoms indicative of chronic PTSD were identified in 25.2% of veterans, as assessed by the Mississippi PTSD Scale. According to the Spielberger–Khanin questionnaire, veterans with subclinical PTSD exhibited a moderate level of situational (44.96 ± 6.39 points) and personal anxiety (44.14 ± 5.49 points), which were significantly higher than those observed in the control group (29.87 ± 6.50, p2 &lt; 0.001, 36.13 ± 6.82, p2 = 0.003). Furthermore, based on the BDI, these veterans demonstrated an elevated level of depression (13.32 ± 1.36) in comparison to veterans without PTSD (8.61 ± 0.65, p &lt; 0.001) and the control group (4.06 ± 0.75, p &lt; 0.0001). The findings indicate that veterans exhibiting a high level of PTSD are characterized by a more pronounced manifestation of psychopathological indicators, as assessed by the SCL-90-R questionnaire. Compared to the control group, veterans exhibiting PTSD symptoms were found to have a comorbidity with somatic diseases: stage 3 hypertension in 45.2% vs. 21.3% (p2 &lt; 0.001), coronary heart disease in 45.5% vs. 13.4% (p2 &lt; 0.001), and type 2 diabetes mellitus in 20.3% vs. 6.1% (p2 = 0.001). Consequently, Afghan war veterans should be regarded as a high-risk group for cardiovascular diseases (including hypertension and coronary heart disease), cerebrovascular diseases, and mental health disorders. Accordingly, a comprehensive approach is necessary to identify PTSD symptoms alongside concomitant anxiety–depressive disorders and somatic diseases in individuals who have experienced traumatic events.

This study aimed to evaluate the effects of COVID-19 fear and anxiety on dietary habits during the COVID-19 pandemic. This cross-sectional study employed an online questionnaire comprising the COVID-19 Fear Scale (FCV-19S), Coronavirus Anxiety Scale (CAS), and Generalized Anxiety Disorder-7 (GAD-7) Test to assess demographic characteristics, eating habits, and levels of fear and anxiety. While meal skipping decreased after the pandemic compared to before the pandemic, snack consumption increased (p

Normal Weight obesity, characterized by normal-range body mass index accompanied by elevated adiposity, poses a potential health challenge among female college students. This demographic exhibits heightened susceptibility to psychological disturbances and sleep disorders. High-Intensity Interval Training (HIIT) appears to have potential in managing metabolic dysregulation. However, its efficacy in improving mental health and sleep quality in individuals with normal weight obesity remains uncertain. This randomized controlled trial enrolled female college students (N = 35) who met the criteria for normal weight obesity, defined as a body mass index between 20 and 23kg/m² and a body fat percentage greater than 30%. The intervention group (n = 17) participated in a 4-week HIIT protocol, consisting of five sessions per week at greater than 90% VO2max, while the control group (n = 18) received standard health education. Validated instruments were utilized to assess depression (PHQ-9), anxiety (GAD-7), and sleep quality (PSQI). ChiCTR2100050711 Registered 3 September 2021 Retrospectively registered, https//www.chictr.org.cn/showproj.html? proj=132,914. The HIIT intervention significantly reduced PHQ-9 scores from 5.8 ± 4.2 to 3.2 ± 2.7 (p < 0.01) and GAD-7 scores from 5.1 ± 5.3 to 2.8 ± 2.9 (p < 0.05), while also improving PSQI scores from 5.1 ± 3.4 to 3.5 ± 2.5 (p < 0.01). Post-intervention analyses revealed a strong correlation between sleep quality and levels of depression (R = 0.813, p < 0.001) and anxiety (R = 0.739, p < 0.001) in the HIIT group, whereas no significant change in sleep quality was observed among the control group. This study demonstrates the therapeutic efficacy of HIIT in improving psychological disturbances and sleep architecture in female students with normal weight obesity. It may serve as a time-efficient intervention. The observed correlation between sleep quality and psychological parameters warrants further investigation into the underlying mechanisms.

Premenstrual syndrome (PMS) is prevalent among young women and may influence both mental well-being and circadian patterns. Premenstrual Syndrome (PMS) has been associated with circadian rhythm disruptions, as circadian rhythms regulate physiological and biological functions throughout the day. This study investigates the impact of PMS on mental health and its association with chronotype and social jetlag among nursing students. This cross-sectional descriptive and comparative study included 98 female nursing students enrolled at a university during the spring semester of 2023. Participants who provided informed consent via Google Forms were classified into PMS and without PMS groups according to their Premenstrual Syndrome Scale (PMSS) scores. Data were collected using the PMSS, Morningness-Eveningness Questionnaire (MEQ), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Social Jetlag Questionnaire. The participants' mean age was 21.13 ± 1.46 years, their mean body mass index (BMI) was 21.75 ± 3.04, and the mean total PMSS score was 135.45 ± 42.64. Students with PMS exhibited significantly higher depression (p < 0.001, O. R = 1.126) and anxiety scores (p < 0.001, O. R = 1.094) than those without PMS. PMS presence significantly affected both depression and anxiety scores (p < 0.001, Std. Beta = 0.474; p < 0.001, Std. Beta = 0.429, respectively). No statistically significant impact of PMS on social jetlag or chronotype was observed. However, in the group with PMS, a positive and significant correlation was found between PMSS total score and social jetlag (r = 0.351, p = 0.013) and BAI total scores (r = 0.350, p = 0.013). This study demonstrates that PMS significantly affects the mental health of nursing students, as those with PMS reported higher levels of depression and anxiety. Furthermore, the finding that social jetlag and anxiety increased as PMS severity increased suggests that circadian rhythm irregularities may be a factor to consider in symptom management. This study has some limitations, including the use of self-reported data and a relatively small sample size, which may affect the generalizability of the findings. It is recommended that future research should confirm these relationships with larger samples and longitudinal designs.